4 Important Differences Between Psoriasis and Eczema

By Beth Ward

Itchy, irritated skin and blotchy, red patches are just two symptoms that psoriasis and eczema share that can make it hard to tell the common skin conditions apart. Both psoriasis and eczema may have similar triggers, too, like stress, and neither of the conditions is contagious.

These similarities can make psoriasis and eczema tough for doctors to diagnose, but being aware of some of the differences can help you get the proper diagnosis and treatment for your particular skin woes.

For starters, eczema is a general term used to describe a set of itchy skin conditions that can be caused by dry skin, certain illnesses, contact with an allergen or irritant or even stress. It’s most commonly an inflammatory response that happens when an allergen or irritant comes in contact with sensitive skin. Psoriasis, however, is a genetic autoimmune condition where skin cells grow too quickly, resulting in thick and uncomfortable raised patches of skin.

Here are four more important differences between eczema and psoriasis.

1. The time of onset is different.

Eczema is most common in babies and young kids. In many cases, the symptoms will become less severe as the child gets older, and the skin condition may also occur in adults.

Psoriasis can begin at any time, but it’s most common between the ages of 15 and 30. It’s also not unusual for psoriasis to begin later in life, between 50 and 60.

2. Other than the red, itchy skin, the two conditions look different.

Eczema causes skin to appear red, dry and cracked. In severe cases the skin can also blister and weep, and certain types can cause your skin to look discolored. Eczema can also appear as fluid-filled bumps. Symptoms can occur anywhere, but you’re most likely to see them on the face in babies, and also on the scalp, chest and back, neck, wrist, ankles and in soft areas of the skin that bend, like inside the elbows and knees.

Psoriasis causes thick red or white patches that can also appear silvery and scaly. These patches can appear anywhere on the skin, but they’re most likely to show up on the outsides of the knees and elbows, the lower back and on the scalp. Psoriasis also causes pitting in the nails, making them brittle or potentially causing them to crumble and fall off.

3. They aren’t triggered by all of the same things.

Eczema triggers are different depending on the type that you have. But the most common causes of flare-ups include soaps, laundry detergents, certain foods, environmental allergens like dust and pets, as well as viruses, cold, dry air and itchy materials like wool. Stress and sudden changes in temperature can also trigger a reaction.

Psoriasis triggers may include stress, medications such as beta-blockers and lithium, illnesses and dry, cold air. A scratch or bad sunburn could also trigger a flare-up. Some people believe dairy, alcohol, sugar and red meat may also trigger psoriasis flares.

4. Treatment differs for psoriasis and eczema.

People suffering from eczema can use topical creams and lotions to help manage the dryness and irritation, and cold compresses to relieve painful itching. Your doctor might also prescribe an antihistamine or corticosteroid.

Doctors may also prescribe topical or oral treatments for your psoriasis to stop your skin cells from reproducing so quickly. These could include biologics, light therapy, topical corticosteroids, retinoids or salicylic acid. You can also manage the condition at home by taking oatmeal baths to alleviate itching and using a humidifier to help prevent dryness and irritation.